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In early March, as cases of the novel coronavirus were increasing far more quickly than doctors in the United States could detect, the two of us knew we had to change how we and our two small children were living our lives. We canceled birthday parties, medical conferences, restaurant outings, and our children’s classes. We began greeting people without physical contact—not an easy task for two people who are inclined to hug friends and colleagues. We limited time outside our home to essential trips for groceries or work. We joined millions around the world in the unsettling new normal of a physically sequestered life.
As physicians, we understand: The unprecedented drop in human contact across the planet is our best chance to save lives. Much of the discussion of COVID-19 has rightly focused on the millions of lives that could be lost and on the economic recession that may be unleashed as businesses and households cut back their spending. Yet the pandemic could trigger something else: a social recession—a fraying of social bonds that further unravel the longer we go without human interaction. This can have harmful effects on people’s mood, health, ability to work and learn, and sense of community. Just as a strong economy bolsters all of us against losses, social connection is a renewable resource that helps us address the challenges we face as individuals and as a society.
Economic slowdowns are easily measured, and their effects can linger even after the economy begins to grow again. The social recession that COVID-19 could cause will be far harder to quantify, but—as people around the world retreat behind closed doors and sever connections with others—the damage it causes could be no less profound and long-lasting.
Life is just not the same at a distance. Elderly residents of nursing homes are missing family visits. Children cannot play and learn alongside their classmates and friends. Many high-school and college seniors will get a diploma in the mail, rather than enjoying the joyous ceremonies that have produced lifelong happy memories for others. Couples are scrapping long-planned weddings. So much that we all took for granted—meals with friends, office banter, cheering at a game, worshipping with a community—is suddenly on hold.
A social recession is marked by growing loneliness and isolation. Long before the new coronavirus separated people from one another, loneliness was rampant. In 2018, a Kaiser Family Foundation/The Economist study found that 22 percent of adults in America struggle with loneliness. An AARP study in the same year reported that 35 percent of people over the age of 45 are lonely. Studies by the health insurer Cigna in 2018 and 2020 peg the loneliness rate at greater than 50 percent, with particularly high rates among young adults. That these figures vary so widely is testament to the difficulty of quantifying social recessions. Yet by most measures, more adults in the United States struggle with loneliness than smoke or have diabetes. And this is not unique to the United States. Australia, the United Kingdom, Denmark, the Netherlands, and a growing list of other countries, recognizing a profound and widespread problem, have started anti-loneliness initiatives to educate the public and promote community-building practices.
Loneliness is more than a bad feeling. It harms our health, our ability to perform, and our sense of fulfillment. When we were hunter-gatherers, having trusted relationships increased our chances of survival. When we were separated from the members of our tribe, we were in grave danger, which triggered a stress state in our body. Over thousands of years, this stress response to loneliness became baked into our nervous system.
In the short term, the stress of loneliness serves as a natural signal that nudges us to seek out social connection—just as hunger and thirst remind us to eat and drink. But when loneliness lasts for a long time, it can become harmful by placing us in a state of chronic stress. Researchers have found that chronic loneliness is associated with a greater risk of heart disease, dementia, depression, and anxiety. It’s also associated with a shorter life span. Being lonely is associated with a greater increase in mortality than obesity or sedentary living is. According to a 2010 meta-analysis by Julianne Hold-Lunstad at Brigham Young University, the mortality impact of loneliness is similar to that of being an intermittent to moderate smoker.*
Chronic loneliness has many causes—greater geographic mobility; the often isolating effects of technology; a culture that defines success as the pursuit of power, wealth, and fame. When children are asked what their parents want most for them, they say their parents value achievement over being kind to others. But the less we prioritize connections with other people and the more we allow the quality of our interactions to decline, the more our social muscle begins to atrophy. Just like any other muscle, it weakens out of disuse. This can make high-quality social connection even harder.
That’s why the potential effects of physical distance from other people are so worrisome. Enforced separation, even if temporary, threatens to further diminish our social muscle, which has already been weakened by the well-intentioned but isolating forces of the modern world.
In the current crisis, everyone has a role to play—not just in slowing the COVID-19 pandemic but in staving off a social recession. The two of us believe that not only can people maintain social connections during this era of distancing, but that they can also strengthen those connections. Consider these four strategies:
First, spend at least 15 minutes each day communicating with people you love (other than the people you’re living with). Videoconference with them so you can see them and hear their voices, giving you something like the full human experience of connection. You can do it over a meal and have a virtual lunch or dinner together. Fifteen minutes a day isn’t a lot of time, but it will make you feel better immediately and will strengthen your lifeline to the outside world.
Second, make the time you do spend with people as distraction-free as possible. If you live with others, find moments to check in—away from media and your to-do list. Being fully present can give you the space to be open and vulnerable and give the other person that chance too. When reaching out to people virtually, try to focus on the conversation as if the two of you were sitting across from each other. Looking directly at people during a video call makes peeking at Instagram or an email inbox harder. When we eliminate distraction, we increase the quality of our interaction with others. Especially when our time is limited, quality matters.
Third, practice moments of solitude. Solitude, unlike isolation or loneliness, is a feeling of being comfortable and even joyful in your own company. But it’s not easy to come by. Technology has completely filled the white space we once had in our lives—those empty moments when going to work or waiting for a friend at a restaurant.
So start small. Find a few moments a day to put away technology and work and enjoy a few moments of silence. You can use this time for meditation, prayer, or a solo walk in nature. You can give yourself permission to acknowledge whatever complex emotions you’re feeling. You can remember something or someone you’re grateful for. One of us, Vivek, had a physician mentor who would pause and take a deep breath before he entered a patient’s room, using those few seconds to remind himself how grateful he was to have the opportunity to participate in someone’s healing. Such moments give us a sense of grounding that helps us better connect with others.
Fourth, reach out and help others. When we serve others, we not only build a connection to them, but we also remind ourselves that we have value to add to the world. Call to check on an elderly neighbor. Deliver food to the door of a work colleague who might be struggling to work remotely and care for his kids at the same time. Respond with compassion and understanding when family members are more irritable and distracted than usual. And remember that giving others the opportunity to serve by asking for their help can be a form of service, too.
During a crisis like the COVID-19 pandemic, saving lives becomes the highest priority, followed by limiting economic harm. People’s emotional well-being is seldom treated as a matter of utmost public concern. Yet relationships with other people are the foundation on which humans build healthy, fulfilling lives, so we must safeguard them as the threat of a social recession looms ever larger. Indeed, if this crisis can pull back the curtain on the deeper well of loneliness that existed before the pandemic, if it can remind us that weakening social ties make us all vulnerable, and if it can force us to work harder at strengthening the human connections in our lives, we might even emerge stronger and more connected than ever before.
*This article previously mischaracterized the relative effects of loneliness, obesity, sedentary living, and smoking on mortality.
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